Department Of Microbiology Research Articles

CLINICAL AND LABORATORY PROFILE OF ADMITTED PATIENTS PRESENTING WITH FEBRILE ILLNESS DUE TO DENGUE AND SCRUB TYPHUS COINFECTION FROM A TERTIARY CARE HOSPITAL IN SOUTH RAJASTHAN, INDIA

Objective: The present study aims at describing the clinical features, laboratory diagnosis, and complications in patients presenting with febrile illness due to scrub typhus and dengue coinfection from Southern Rajasthan, India. Method: This present prospective, observational, and hospital-based study conducted in the Department of Microbiology of AIMS & RC, Rajsamand, located in Southern Rajasthan, from January 2021 to December 2021. Scrub typhus was diagnosed in the microbiology laboratory by performing SD Bioline, one-step scrub typhus for the detection of IgM antibody, and dengue fever using J.mitra and Co. Pvt. Ltd., rapid card test for the detection of NS1 antigen and IgM antibody. Result: Out of 500 patients suspected of AUFI, 25 (5%) patients diagnosed of having dengue and scrub typhus coinfection. Fever was present in all 25 (100%) patients and 13 (52%) of patients had arthralgia, nausea, and vomiting. The most common sign noticed in our study was pallor and icterus in 10 (40%) patients each followed by shock/hypotension in 8 (32%) and hepatosplenomegaly in 5 (20%). The most predominant laboratory finding was thrombocytopenia (<1.0 × 106/cumm) in 23 (92%) patients, while elevated bilirubin (>2 mg/dl) in 22 (88%) and elevated transaminase and prolonged aPTT in 21 (84%) patients each. The majority of patients 23 (92%) had hepatic dysfunction, i.e., in followed by multi-organ dysfunction (MODS) in 15 (60%). Conclusion: In developing countries like India, particularly in tropical areas, dengue, and scrub typhus coinfection is under-recognized entity. Additional investigation should be carried out in cases of AUFI patients with features such as hypotension, leukocytosis, early drop in platelet counts, and hypoalbuminemia.

Microbial Profile of Corneal Scrapping Samples Received in Department of Microbiology in a Tertiary Care Hospital, Himachal Pradesh

Microbial Profile of Corneal Scrapping Samples Received in Department of Microbiology in a Tertiary Care Hospital, Himachal Pradesh

Comparison of Colistin Susceptibility via Two Different Methods in Gram-Negative Extensive Drug-Resistance Isolates from ICU Patients.

To compare the susceptibility of colistin by two methods in extensive drug-resistant (XDR) Gram-negative isolates from ICU patients. Cross-sectional comparative analysis. Place and Duration of the Study: Department of Microbiology, Combined Military Hospital Karachi, Pakistan, from August 2022 to February2023. A total of 100 clinical specimens received from the intensive care unit yielded growth of extensively drug-resistant gram-negative bacteria, which were evaluated for polymyxin E susceptibility. The agar dilution method was compared with the reference broth microdilution (BMD) method. Minimum inhibitory concentration (MIC) was noted for both methods. Comparison of the MIC method by agar dilution showed a 90% correlation with the reference method of broth microdilution. With MICs within the acceptable range of the clinical and laboratory standards institute (CLSI) recommendations, 89 isolates were susceptible to colistin, whereas only 11 remained resistant. Polymyxin E's MIC 50 and MIC 90 were determined to be 1 and 2 µg/ml, respectively, with 97% susceptibility. Agar dilution susceptibility method can be used for screening purposes for the susceptibility testing of polymyxin E. This method is reliable and can easily identify the heteroresistance. Extensively drug-resistant, Broth microdilution, Multidrug-resistant, Agar dilution, Minimum inhibitory concentration, Colony forming unit.

An Observational Study to Find the Association of Viral Load, NS1 Antigen, IgG Antibody, and Other Laboratory Parameters With the Outcome of Dengue Patients in Eastern India.

Background Dengue, the mosquito-borne febrile disease caused by the dengue virus, has become one of the major concerns of public health. It may present with only fever, or there may be a hemorrhagic manifestation or septic shock. As there is no specific treatment for dengue, early detection of the disease, assessment of progression, and prediction of outcome by studying the laboratory markers will help guide the management of cases and lower morbidity and mortality. Methodology This clinico-observational study was conducted at the Department of Microbiology in a tertiary care hospital in Kolkata, India, from February 2020 to August 2022 to determine the outcome of dengue patients in correlation with viral load, NS1 antigen, IgM and IgG antibodies, ferritin level, platelet count, and other laboratory parameters. Results Out of 316 samples from fever patients, 103 (32.5%) were NS1 antigen reactive. We followed up the dengue patients (n = 103) for 15 days and divided them into three groups according to their duration of symptoms (group A suffered for ≤5 days, group B for 5 to 10 days, and group C for >10 days) and per the WHO classification of disease severity, namely dengue without warning signs (DOS), dengue with warning signs (DWS), and severe dengue (SD). Based on severity, 65 (63.1%) patients had DOS, whereas 31 (30.09%) patients had DWS, and seven (6.79%) patients had SD. Secondary infection was present in 83.33% of patients in group C, 71% of DWS cases, and 57% of SD cases, which positively correlates with liver enzymes, viral load (mean value 102195 in secondary infection vs. 1195 copies/10 µl in primary infection), and negatively correlates with platelet counts (mean value 60,213 in secondary infection vs. 1,25,516 in primary infection). Patients in group C had higher liver enzymes, a lower platelet count, and a higher initial viral load than groups A and B. Similarly, SD cases had a higher ferritin level (9215 ug/l), a lower platelet count (mean value 23,250), and a higher initial viral load (mean value 2,74,257 copies/10 µl). An increase in hematocrit value considering the peak value and its baseline value is an important marker for disease severity rather than its absolute value. Conclusion Poor outcome of dengue infection, i.e., an increase in the duration of symptoms and disease severity depends on concurrent associations between high serum ferritin, increased hematocrit level, thrombocytopenia, secondary infection, increasing liver enzymes, and increased initial viral load.

Relationship between P16INK4a Overexpression in Human Papillomavirus Infection in High Grade CIN and Cervical Carcinoma

Background: High-risk HPV strains are a well-known contributor to the carcinogenesis of cervical squamous cell carcinoma (SCC). Indeed, there has been a high detection of HPV DNA in SCC and precancerous lesions. Objective: The aim of the study was to assess the Relationship Between Human Papillomavirus Infection and P16INK4a Overexpression in Cervical Squamous Cell Carcinoma. Methodology: This descriptive cross-sectional study was carried out in the Pathology Department of DMC with collaboration of Bangabandhu Sreikh Mujib Medical University (BSMMU), Microbiology Department and Bangladesh Agricultural University (BAU), Mymansingh, during July 2017 to June 2018. A total 50 VIA positive and clinically suspected premalignant and malignant patient’s attendant at DMC included as study population. Colposcopic biopsy specimens were sent to the Department of Pathology, DMCH, for histopathological examination. Some portion of biopsy samples were preserved at -4ºC for HR-HPV DNA detection. Statistical analyses were done by using the SPSS 26.0. Result: Highest number of cases 20 (40%) were in fourth decade and their mean age was found to be 44.20±11.20, ranging from 28 to 67 years. Among 50 positive cases, maximum number of 32 (62%) cases were married between 16 to 20 years of age, 12 (22%) cases were married in less than 15 years of age and 6 (8%) cases were married at more than 20 years of age. The findings of colposcopic examinations of total 50 cases. Common diagnoses were CIN II in 24 (48%) cases, 8(16%) case represented CIN III, Squamous cell carcinoma in 16 (32%) cases and Adeno Carcinoma 2(4%) cases. In comparison of p16 score with cervical lesions in study subjects there were 26 true positive cases and 13 true negative cases. According to p16 score a total 37 (26 true positive+ 11 false positive) cases were p16 positive. Out of which 16(32.0%) and 21(42.0%) were HR-HPV positive and negative respectively. Similarly according to p16 score 13 nevative cases ........

Beyond the gut - Atypical presentation of Salmonella spp. infection

Abstract Salmonella is a Gram-negative, non-spore-forming, motile, facultative anaerobic rod. The most studied species are Salmonella typhi and paratyphi (causing typhoid fever) and non-typhi Salmonella species (which can cause different clinical syndromes - gastroenteritis, disseminated infections, etc.). A 61-year-old male patient with multiple comorbidities (including myelofibrosis) presented to the Pulmonology outpatient department, Clinical County Hospital of Târgu Mureș, with a mucopurulent nocturnal cough. Paraclinical examinations showed the presence of a pleural empyema, which was evacuated in local anesthesia. The pleural fluid was sent to the Microbiology Department for bacteriological testing, where a fluoroquinolone-resistant strain of Salmonella spp. was detected. The patient received antibiotic treatment according to the antibiotic susceptibility testing. Due to the persistence of the symptoms, the patient returned two weeks later, when another puncture was performed. Salmonella was isolated again, but the strain showed a higher resistance to antibiotics. The two strains were compared using molecular methods of diagnosis (Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction - ERIC-PCR), the results showing a similarity of 92%. The occurrence of an extra amplicon band in ERIC-PCR suggests an important change in the bacterial genetic material, potentially related to acquisition of antibiotic resistance factors.

Microbial Pattern of Neonatal Sepsis in the Neonatal Intensive Care Unit of dr. Ramelan Navy Central Hospital.

The morbidity and mortality rates from neonatal sepsis remain high. However, there is limited information about the microbial pattern of neonatal sepsis in Indonesia. Microbial patterns can give an overview of the hygiene of an environment and act as a determinant for choosing definitive antibiotic treatment in neonatal sepsis patients. The organisms that cause neonatal sepsis differ from unit to unit and from time to time within the same unit. This study is aimed at discovering the microbial pattern of neonatal sepsis in the Neonatal Intensive Care Unit (NICU), dr. Ramelan Navy Central Hospital, in 2021-2022. This is a retrospective, cross-sectional study that takes secondary data from the NICU and clinical microbiology department of dr. Ramelan Navy Central Hospital. Data that met the inclusion and exclusion criteria available between January 1, 2021, and December 31, 2022, were collected. Patients whose blood cultures were positive for bacterial growth and diagnosed with sepsis were selected as the study sample. Out of 174 samples, 93 (53.4%) were found positive for bacterial infection and diagnosed as neonatal sepsis. Gram-negative isolates (96.8%) were predominant. Sixty-point-two percent of Klebsiella pneumoniae XDR, 19.4% of Klebsiella pneumoniae ESBL, and 8.6% of Burkholderia cepacia XDR were identified. The gram-positive isolates found in this study were only 3 samples (3.2%). Two-point-one percent of MRSA and 1.1% of Staphylococcus haemolyticus MDR were identified. The most common microorganisms causing neonatal sepsis in our NICU were gram-negative bacteria, particularly Klebsiella pneumoniae XDR. Following the recommended infection control procedures, practicing good hand hygiene, and having access to basic supplies and equipment are important to prevent and reduce the incidence of sepsis.

Oral tobacco-free nicotine products: Quality and safety during storage

Oral non-tobacco nicotine products have gained enormous popularity in recent years. The countries of the Eurasian Economic Union also produce and sell this type of innovative but poorly studied goods. As a result, the safety profile and quality of such products as nicotine poaches require urgent comprehensive research. This study featured the changes in quality of nicotine poaches during storage, i.e. nicotine content, water activity, and microbiological index. The research featured nicotine poaches of several popular brands. The authors used standard research methods; the experiments were performed in the laboratory for chemistry and quality control, Institute of Tobacco, Makhorka, and Tobacco Products, Krasnodar, and at the Department of Bioorganic Chemistry and Technical Microbiology, Kuban State Technological University, Krasnodar. The water activity was 0.8911–0.9502 Aw at the initial stage and remained stable in most samples even after six months of storage. Velo Freeze was the only brand to show significant variations in water activity. The nicotine content was 10.115–12.950 mg/g at the initial stage. Only four samples maintained the initial values after six months of storage. The fluctuations of nicotine content were also mentioned by the manufacturer. The microbiological profile remained stable during the six months of storage and met the requirements for similar products, i.e., chewing gum and unglazed caramel. The project needs further research because the qualitative characteristics of nicotine poaches provided rather unambiguous results. Our study will help develop state standards for oral nicotine products. The results obtained will be used to formulate proposals to the organizations responsible for the future Technical Regulations of the Eurasian Economic Union for nicotine products.

Synergistic effects of silver nanoparticles in combination with ineffective antibiotics against multidrug resistant Salmonella typhi.

To determine the antimicrobial activity of silver nano-particles(AgNPs) with tetracycline and ampicillin against multi-drug resistance (MDR) and extensively-drug resistance (XDR) Salmonella typhi. Cross sectional non-probability purposive study was conducted from September, 2021 to May, 2022 at Microbiology department PNS Shifa, Hospital Karachi. Blood cultures of patients suspicious of typhoid fever were collected and incubated in automated Bact/Alert system. Positive cultures were identified on blood and MacConkey and processed by API-10S, confirmed by serotyping (O9 antisera) (SSI Diagnostica's Salmonella). Antibiotic resistance was done by Kirby-Bauer disk diffusion (Sigma and Rich). MDR and XDR isolates were preserved in Brain Heart Infusion in a volume of 2ml in screw capped bottles at -70°C. Antimicrobial powders (ampicillin and tetracycline (Alfa Aesar) weighed by an electrical weighing balance (OHAUS) to take 1mg of antimicrobial drug. Absorbance spectra of serial concentrations of antibiotics (UV-Vis spectrophotometer (Mole-Qule-) AgNPs (10nm) (nanocomposix) + Antibiotic in (1:1 volume ratio). Conjugation of silver nanoparticles with tetracycline and ampicillin was done by FTIR (thermos scientificThermos ScientificNicolet 50). Out of 77 isolates, 54 were resistant to ceftriaxone (XDR) and 23 sensitive to ceftriaxone (MDR). All isolates were susceptible to azithromycin and meropenem. Comparison of zone of inhibitions of ampicillin and Amp-AgNPsas and tetracycline with Tet-AgNPs was done. Minimal inhibitory concentration was also done to determine antimicrobial activity. Significant synergistic inhibitory effects against Salmonella Typhi isolates were obtained by combination of tetracycline with silver nano-particles even at low concentration.

Effect of Incubation Time on Zone Size of Antimicrobials by Disk Diffusion Method for Pseudomonas Aeruginosa

Background: Pseudomonas aeruginosa is a prominent pathogen in healthcare settings, notorious for its rapid development of resistance to multiple antimicrobial agents. Effective susceptibility testing is critical for managing infections caused by this bacterium. This study investigates the impact of varying incubation times on the efficacy of the disk diffusion method. Objective: To evaluate the influence of incubation time on the zone sizes of antimicrobials against Pseudomonas aeruginosa using the disk diffusion method in a tertiary care setting. Methods: Conducted at the Microbiology Department of Combined Military Hospital, Lahore, from October 2022 to March 2023, this descriptive study included 71 clinical isolates of Pseudomonas aeruginosa. Samples were inoculated on Mueller Hinton Agar and incubated at 35°C ±2°C for 6, 10, and 24 hours. Antimicrobial susceptibility was tested using a panel of clinically relevant antibiotics in triplicate, with zone sizes interpreted according to Clinical and Laboratory Standards Institute guidelines. Results: Among the isolates, 59.15% were from males and 40.85% from females. The most affected age group was 15-60 years, comprising 59.52% of cases. Antimicrobial response varied with incubation times: Ceftazidime, Piperacillin-Tazobactam, and Cefepime showed increased zone sizes over time, while Tobramycin’s zones steadily enlarged. Colistin consistently produced the largest zones at all time points. Conclusion: The study highlights the significance of incubation time in disk diffusion testing for Pseudomonas aeruginosa. Adjusting incubation times can expedite results without incurring additional costs, enhancing the efficiency of antimicrobial susceptibility testing in clinical settings.

Seroprevalence of Hepatitis A virus and Hepatitis E virus in patients presenting with acute viral hepatitis: A retrospective study of 2-years at tertiary care Hospital, Himachal Pradesh in Northern India

: Hepatitis-A virus and Hepatitis-E virus are spread enterically, resulting in acute viral hepatitis (AVH) in developing countries. Fecal-oral transmitted hepatitis cause major health problems in our country. The aim of present study is to determine the seroprevalence of HAV and HEV in AVH patients attending the tertiary care hospital at Dr. Rajendra Prasad Govt. Medical College Kangra at Tanda, Himachal Pradesh (DRPGMC). Insufficient data makes it difficult to determine an accurate prevalence of illness in this region of India.: The Viral Research and Diagnostic Laboratory (VRDL), in the Department of Microbiology at DRPGMC Tanda, Himachal Pradesh, consolidated retrospective data of 2-years duration. The study population included 784 serum samples received from outdoor and indoor patients were considered in the study.: Of the 784 serum samples that were chosen for our study, HAV and HEV reactive patients showed a seroprevalence of 11.20% and 1.80% respectively. During two years of the study, the co-infection rate of HAV and HEV in patients with acute viral hepatitis was 0.5%. Compared to females (31.80% and 42%), males reported higher seroprevalence of HAV (68.10%) and HEV (57.10%). Further data shows that HAV infection was observed in all age groups and the highest prevalence was reported in the age range from 11 to 20 years. The HEV infection was not observed in the pediatric age groups, it was only observed in adults. Maximum prevalence of HEV was reported in the age group of 21-30 years. The highest number of reactive cases was recorded in the month of August and September.: We found that the prevalence of HAV is significantly higher than that of HEV during two years of study period. In this study, we observed that HAV is more predominant in males as compare to females.HEV infections were only observed in adults.

Prevalence of Intestinal Parasites among Diabetes Mellitus Patients in Tertiary Care Hospital

Intestinal parasitosis constitutes a serious problem of public health, especially in developing countries. Even though the population of immunocompromised individuals is growing, this is a primary cause of illness and mortality. Numerous studies have demonstrated that immunosuppressive medications, such as those used after transplantation, as well as immune suppression as a primary immunodeficiency in HIV infection, increase the possibility of infection and persistent states of carriage. People whose immune systems were weakened, like in the case of chronic internal disorders or abnormal metabolism, were thought to be more susceptible to infection. A group of metabolic non-communicable diseases known as diabetes mellitus (DM) are characterized by hyperglycemia or elevated blood sugar, which can be brought on by either inadequate secretion of insulin, insulin-resistant cells, or both. Parasitic infections in immunocompromised people are becoming more well-known as major opportunistic microorganisms that cause clinical illnesses. The goal of this research is to see how common intestinal parasite infections are in people with diabetes. The research was carried out at the Chandulal Chandrakar Memorial Medical College, Bhilai, Durg district of Chhattisgarh, India. From March to August 2020, diabetic patients who visited hospitals were studied in this cross-sectional study. This study comprised 188 diabetic individuals with type I or type II diabetes who were taking anti-diabetic medication. With a little spoon and a sterile, dry, leak-proof plastic container with a tight-fitting cover that had the patient’s name and identification number on it, the feces samples were taken. The container was then quickly sent to the parasitology lab of the microbiology department for processing. Stool samples were examined under three headings: macroscopic examination, microscopic examination, and formal ether concentration procedure. A total of 188 DM patients was included with data on socio-demographic characteristics, and from each patient stool sample were collected and processed. Out of which, 27 stool samples were positive for intestinal parasites; showed a prevalence of 14.36%. Female 16 (16.49%) revealed a greater frequency than that of men 11 (12.09%). The age range of 51 to 60 years old exhibited the highest incidence 8 (29.63 %). Stool samples were positive for intestinal parasites with one suffering from a dual infection. Various parasites were detected in which Entamoeba histolytica 10 (5.32%) was most common parasite to isolate followed by Ascaris lumbricoides 9 (4.79%) and Giardia lamblia 6 (3.19%) was least isolated parasite. The most prevalent isolated parasite was Entamoeba histolytica, which was followed by Cryptosporidium parvum. Diabetic patients have an increased risk of parasitic infections, particularly when they have the opportunistic infection Entamoeba histolytica. Patients with diabetes who have been diagnosed with Cryptosporidium parvum have a weaker immune system. Therefore, for the sake of societal welfare, people with diabetes mellitus should have routine stool examination screening for parasite infection.

Microbiological Assessment of Commercial Antibiotic Discs from selected Pharmacies in Bwari Area Council, Abuja, Nigeria

Aims: To assess the potency of two brands of locally prepared antibiotics against two bacterial species. Place and Duration of Study: Department of Microbiology, Veritas University, Abuja, Nigeria, between September 2021 and February 2022. Methodology: We purchased two brands of antibiotics and obtained our test isolates from General hospital in Bwari, Abuja. The test isolates were characterized both routinely and molecularly by Sanqer sequencing method to confirm the species. Agar diffusion method was employed to assess the effectiveness of the antibiotics on the test isolates. Finally, the results were compared with the Clinical and Laboratory Standards Institute (CLSI). Results: The isolates obtained from the Bwari Genera l Hospital were characterized routinely and molecularly to identify the species. Disc - agar diffusion modified method was employed while the potencies of the discs were compared with approved standards of the Clinical and Laboratory Standards Institute (CLSI). The two brands which are locally made and available in multidisc panels, demonstrated performances against Staphylococcus sciuri and Proteus mirabilis but showed significant variations in concentrations and in their inhibitory zone diameters. Both brands containing Tarivid (10 µg) produced only a small zone against Proteus mirabilis, while Streptomycin (30 µg) and Gentamycin (10 µg) exhibited unreadable zones against Staphylococcus sciuri. Unreadable zones of inhibition, which implies large zones that merged together and exceeded plate diameters at the time of reading; were common with both brands and can lead to mis-information, increase in the susceptibility of resistant organisms and eventually, drug abuse. Conclusion: The result of this assessment shows, that there is gross variation in these commercially available but locally prepared antibiotic discs. The disparity in the types of antimicrobial agents and their concentrations will pose a delicate problem to clinical microbiologists and subsequently in the diagnosis, administration of antibiotics and the likelihood of drug resistance.

«A brilliant teacher and popularizer»: Professor Pavel Nikolaevich Kashkin (1902-1991)

The essay based on archival materials reveals the major milestones in the biography, scientific, pedagogical, and public activities of the eminent scientist, professor, Doctor of Medical Sciences, and Candidate of Biological Sciences, P.N. Kashkin, who headed the Department of Microbiology at the Leningrad Chemical-Pharmaceutical Institute. He was not only the founder but also one of the initiators of the reorganization of the Chemical-Pharmaceutical Faculty of the 1st Leningrad Medical Institute in the period 1936-1937 and the establishment of the Leningrad Chemical-Pharmaceutical Institute as an independent university. P.N. Kashkin was the author of numerous discoveries, a mentor who raised and inspired a whole generation of scientists. P.N. Kashkin became the initiator and organizer of the world's first Engineering Microbiology Faculty at the LCFI, where he served as the dean. His main task was the training of highly qualified specialists for the developing industry of antibiotics, including antifungal drugs. P.N. Kashkin is the founder of mycosis epidemiology in our country. The name of Professor P.N. Kashkin as a prominent specialist became known among mycologists thanks to his work on organizing the fight against fungal skin diseases. The name of the founder of domestic microbiology, P.N. Kashkin, was assigned to the St. Petersburg Research Institute of Medical Mycology, and in 2005 a monument to this remarkable scientist was erected on the institute's premises.

Addressing the Global Threat of Multidrug-Resistant Infections: The Role of Ceftazidime-Avibactam Revisited.

Background and objective Bloodstream infections (BSIs) due to multidrug-resistant Gram-negativebacteria(MDR-GNB) pose a significant global health threat amid rising antimicrobial resistance (AMR). This study aimed to investigatethe efficacy of ceftazidime-avibactam (CZA) as a therapeutic option for these infections, addressing the urgent need for novel treatments. Materials and methods This study was conducted over one year in the Department of Microbiology, JSS Medical College and Hospital, Mysuru, India, and employed a laboratory-based prospective design. From a total of 376 positive blood cultures, 147 multidrug-resistant (MDR) organisms were identified, and 100 were randomly selected for final analysis. Susceptibility testing via disk diffusion and minimum inhibitory concentration (MIC) determination was performed to evaluate CZA efficacy. Results Klebsiella pneumoniae (K. pneumoniae)was the predominant (78%) organism among the subsets, with varying susceptibility patterns observed across species. The overall CZA susceptibility was 45%, with significant discrepancies between disk diffusion and gold standard testing. Notably, there was limited efficacy against Pseudomonas aeruginosa (P.aeruginosa) Conclusions This study underscores the pressing need for reliable testing methods and novel treatment strategies in combating MDR infections. Further research with larger sample sizes is imperative to validate our findings and guide clinicians effectively in addressing this critical health challenge.

Insights into hepatitis B virus infection among pregnant women: Assessing seroprevalence, serological, and virological profile at a tertiary care hospital in India

ABSTRACT Background: India bears a considerable global burden, hosting over 37 million hepatitis B virus (HBV) carriers, primarily transmitted through the perinatal route. Therefore, this study aimed to determine the prevalence of HBV infection among pregnant women attending the antenatal clinic at a tertiary care hospital. Aims: This study sought to assess the seroprevalence of HBV infection in pregnant women, analyze the serological markers of HBV infection, and ascertain the viral load of HBV DNA. Settings and Design: The study was conducted at the Department of Microbiology and Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. It adopted a hospital-based cross-sectional design. Subjects and Methods: The study spanned from January 2021 to June 2022. HBV infection among pregnant women attending the antenatal clinic of a tertiary care hospital was identified by screening their sera using hepatitis B surface antigen (HBsAg) ELISA. For samples testing positive for HBsAg ELISA, additional tests were administered, including HBeAg, HBeAb, hepatitis B core immunoglobulin M, and total hepatitis B core antibody (immunoglobulin [Ig] M + IgG) by ELISA. In addition, a quantitative assessment of HBV DNA was conducted using real-time reverse transcription-polymerase chain reaction. Statistical Analysis Used: All data underwent coding and entry into an MS Excel spreadsheet, with analysis executed using the Statistical Package for the Social Sciences (SPSS) version 21.0. Ethical approval was obtained from the Institutional Ethics Committee, Vardhman Mahavir Medical College and Safdarjung Hospital. Informed consent was obtained from all pregnant women participating in the study. Results: Among the 1519 pregnant women screened for HBsAg, 15 tested positive, resulting in a seroprevalence of 1% (15/1519). Subsequent examination revealed two women with acute HBV/chronic hepatitis B-acute exacerbation infections (high infectivity) and 13 women with chronic HBV infections (low infectivity). Furthermore, only HBeAg-positive women exhibited HBV DNA levels surpassing 2000 IU/mL. Conclusions: The 1% seroprevalence of HBV among pregnant women implies an approximate count of 4 million infected women of reproductive age, posing a risk of vertical transmission to nearly 4 million newborns annually. With HBeAg-positive mothers, the risk of neonatal transmission ranges from 70% to 90%. Timely interventions for all pregnant women are imperative to mitigate HBV vertical transmission.

Chronic dacryocystitis: An insight into bacteriology and antimicrobial sensitivity pattern.

Adequate management of chronic dacryocystitis is an essential prerequisite before any intraocular surgery owing to a grave risk of endophthalmitis. The knowledge of bacteriology of chronic dacryocystitis would accentuate the choice of effective antimicrobial agents and thus help in reducing the irrational use of antimicrobial agents and subsequent development of drug resistance. We aimed to identify the causative bacterial flora and study the antimicrobial sensitivity and resistance pattern in cases of chronic dacryocystitis. This was a cross-sectional observational study. Conjunctival swabs were obtained from both eyes from 102 patients with clinical evidence of chronic dacryocystitis. Specimens for microbiological analysis were obtained, either from the conjunctival cul-de-sac and everted puncta by applying pressure over the lacrimal sac area or from the refluxing material after irrigating the lacrimal sac with sterile saline. The specimens were sent for culture and sensitivity in the department of microbiology. Ethical approvals were duly obtained. Percentage assessment was used for statistical analysis. The cultures showed the presence of Staphylococcus aureus in 50% of bacterial isolates obtained from the involved eyes, followed by coagulase-negative Staphylococcus in 11.53% of isolates and Enterococcus also in 11.53% of isolates. It was observed that cefoxitin was the most sensitive antibiotic against Gram-positive organisms, followed by vancomycin and clindamycin, whereas maximum resistance was seen for penicillin and ofloxacin. For Gram-negative organisms, imipenem was found to be most sensitive, followed by gentamicin and co-amoxiclav, whereas maximum resistance was seen for ciprofloxacin. It was concluded that Gram-positive bacteria predominantly S. aureus was the most commonly isolated bacteria in cases of chronic dacryocystitis as compared to Gram-negative bacteria and cefoxitin was found to be the overall most effective antibiotic for Gram-positive bacteria.

Screening of Syphilis Using the Reverse Algorithm and its Trends Among Healthy/Asymptomatic Blood Donors: A Regional Transfusion Centre Study from Northern Pakistan

Objective: To determine the syphilis trends by using the reverse algorithm in healthy/asymptomatic blood donors from Northern Pakistan. Study Design: Perspective longitudinal study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Transfusion (AFIT), Rawalpindi Pakistan, from Jan to Sep 2022. Methodology: After taking a complete history from potential donors, an appointed blood bank doctor performed a general physical examination. Potential donors’ blood samples were tested for syphilis by the Chemiluminescent Microparticle Immunoassay (CMIA) method followed by reflexively testing of CMIA reactive blood samples with Rapid Plasma Reagin (RPR), and results were interpreted as positive or negative. Results: A total of 56122 donors donated blood over nine months, including 55742(99.3%) males and 380(0.7%) females. Blood donors ranging from 18-65 years with a mean age of 28.82±7.1 were included in the study. Out of 56122 blood donor samples submitted, 487(0.87%) turned out to be syphilis positive by CMIA method, comprising 485(99.59%) males and 02(0.41%) females. Of 487 CMIA-positive serum samples, 216(44.3%) were RPR-positive, all male donors. Conclusion: A higher latent syphilis trend was observed in replacement non-voluntary young male donors between 18 and 40 years of age. The majority of the syphilis positives donors were male, while females made up a negligible percentage.

Role of Lifestyle Risk Factors for Azoospermia: Insights from Ebenezer Clinical Laboratory - Kampala Capital City, Uganda

Background: Azoospermia is one of the social problems affecting families/countries today in the whole world, which has resulted in an involuntary declining birth rate [1]. Worldwide, more than 70 million couples suffer from infertility, and it is estimated that azoospermia is found in up to 10 to 20 percent of the men who present to an infertility clinic [2]. Uganda is among the countries where male infertility is assumed to be a big challenge, with an estimated 5,000,000 people facing infertility, where 10 to 15% of the couples are unable to have children. Hence the current study aimed at establishing the risk factors associated with azoospermia among patients attending Ebenezer Clinical Laboratory, Kampala, Uganda. Methods: A retrospective case-control study design was conducted on men who had visited the Microbiology Department for semen analysis from 1st January to 31st December 2015. Cases were azoospermic participants in the ECL database with no sperm cells in the ejaculate whereas controls were normozoospermic participants in the ECL database with normal sperm cells in the ejaculate. Systematic sampling was employed in the selection of respondents using their clinical records. The sample size was 204 (102 cases and 102 controls) clients, determined using a formula from the OpenEpi software package for Kelsey. The sample involved 102 cases and 102 with a ratio of cases to controls being 1:1. The study used a data abstraction structured questionnaire for data collection. Data was analyzed using descriptive statistics to generate frequencies and percentages. Chi-square test and logistic regression analyses were used to determine whether there was a significant association between risk factors and azoospermia with about 0.05 statistical significance. Results: The study found out that tobacco use [AOR = 11.245, (CI 95% = 3.913 – 32.312), p = 0.000], marijuana use [AOR = 21.975, (CI 95% = 5.710 -44.571), p = 0.000], type of underwear [AOR = 9.366, (CI 95% = 4.360 – 19.9471), p = 0.000] were statistically significant factors associated with azoospermia among patients Conclusions: Interventions should be focused on improving these factors, such as minimizing tobacco and marijuana usage among the populations, as well as sensitizing the males on the dangers of wearing tight underwear.

PCR Detection of Extended Spectrum β-Lactamase from Some Gram Negative Bacteria of Clinical Source

Beta-lactamase-producing microorganisms present distinct challenges in health care systems around the world as a result of the extensive utilization of broad-spectrum antibiotics. The objective of this research endeavor was to ascertain the antibiotic resistance profile and presence of β-lactamase genes in Gram-negative bacteria that had been previously identified and collected from laboratory work benches at the Department of Microbiology and Parasitology, UCH, located in Ibadan, South-West Nigeria. The Kirby-Bauer disc diffusion method was used to assess antibiotic susceptibility on all the isolates, and the double disc synergy test was used to validate extended spectrum beta-lactamase (ESBL) production phenotypically. The PCR techniques were used to detect β-lactamase genes. The sample distribution of the forty clinical isolates were collected from the work benches and the distribution was: urine (17), blood (9), wound (6), sputum (4), amniotic fluid (3) and tracheal aspirate (1). Klebsiella pneumoniae was the most prevalent organism with 17 isolates ( 42.5% ). Out of the 40 isolates that were obtained, 21 were ESBL producers and the distribution was as follows: Klebsiella pneumoniae (9), Escherichia coli (6), Enterobacter cloacae (2), Enterobacter aerogenes (1), Pseudomonas aeruginosa (1), Acinetobacter baumannii (1) and Hafnia alvei (1). The majority of the clinical isolates showed considerable resistance to antibiotic classes that were tested, with amoxicillin-clavulanate showing the highest resistance rate at 65%. Out of all the ESBL producers, 35.3% had blaTEM, 29.4% had blaCTX-M, 23.5% had blaSHV, and 11.8% had blaCMY. AmpC β-lactamases, Antibiotic resistance, Disc diffusion, Gram-negative bacteria, Polymerase chain reaction.